COVID19 among kids
One of the pandemic’s biggest mysteries is the infection (and spread) of COVID19 among kids.
In the US, children account for 22% of the population but only account for 1.7% of COVID19 cases. This is VERY odd. Usually kids and elders are hit hardest in endemics and epidemics. HOWEVER, these past two weeks we have been finding more kiddos with infection. Why? The virus explosion is so widespread that it is touching everyone in our community.
There are a few studies (and educated guesses) as to why kids are infected at lower rates than adults:
#1: Children don’t get the disease as easily as adults. A study in New York found that this is because kids have less “open doors” on their cells for COVID19 to enter. One study in Israel found that for every 100 adults that are infected, 9 1-5 year olds are positive under the same circumstances. In a Chicago study, 73% of household infections was adult-to-child transmission, 13% child-to-child; and 13% child-to-adult transmission. Kids are just not as susceptible to the virus.
#2: Majority of children don’t show symptoms of COVID19. So, they aren’t tested. We don’t know the “true” number of kids infected. This hypothesis could get scary, because studies in Germany and South Korea have shown that once a kid IS infected, they are just as infectious as adults.
#3: Along similar lines, kid’s tiny nasal pathways may impact the accuracy of a COVID19 test. In other words, testers just don’t get the right amount on the swab and the disease goes undetected. A China study found that among children who tested negative TWICE, 24% had a CT scan that confirmed COVID19. A study in Seattle found that among children who tested negative, most children had COVID19 antibodities. The kids’ cases were missed.
There are certainly other non-medical factors to consider too. One major concern of ours is the impact of closed schools on childhood development AND safety (i.e. child abuse and neglect). These hypotheses will take a whole lot more time for science to test, but we have lots of studies (pre COVID19) and antidotal evidence (during COVID) that show both are happening as we speak.
Translation: So do we open schools? I don't know. I have an opinion, but no data-driven answers. I’m just glad that I don’t have to make the decision. All school policies thus far have been emotionally driven rather than scientifically. Which is FINE, these are our babies. But it may be smart to start thinking strategically.
Love, your local epidemiologist
Data Sources: Here are the scientific studies I mentioned above.
New York study: https://jamanetwork.com/journals/jama/fullarticle/2766524 Israel study: https://www.medrxiv.org/…/2020.06.03.20121145v1.full.pdf+ht… Chicago study: https://academic.oup.com/…/doi/10.1093/jpids/piaa070/5849922 Germany study: https://virologie-ccm.charite.de/…/Charite_SARS-CoV-2_viral… South Korea study: https://wwwnc.cdc.gov/eid/article/26/10/20-2449_article China study: https://bmcmedicine.biomedcentral.com/…/…/s12916-020-01596-9 Seattle study:https://www.medrxiv.org/conte…/10.1101/2020.05.26.20114124v2